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"The attack on the church is real," Dr. Michael Fernandez, an OB-GYN in Virginia, tells me. Fernandez, a Catholic, is yet another former Barack Obama voter who is changing his vote this time around.

"I feel that he has divided the country," the 22-year veteran of Arlington Hospital says. And this comes from a voter who was going to give the president a chance even after believing that Obama "lied to pro-life Democratic congressmen for votes to ram the health plan through without popular support." Fernandez still would have considered voting for the president in his reelection bid, he says, until "the HHS mandate and the attack on the church."

Reflecting on the 2008 election, Fernandez recalls: "He presented himself as a person who would unite the country after bitter partisanship for the previous 16 years. He would be post-partisan. I wanted an end to the suffering of people without accessible health care. I did not believe that his agenda was to force hospitals and doctors receiving government insurance reimbursement to provide abortion services." While Fernandez was realistic and "never thought [Obama] was the messiah," he was impressed with Obama's all-American story.

Fernandez ceased to be a Democrat when the Obama administration's Department of Health and Human Services abortion-drug, sterilization and contraception mandate went into effect on Aug. 1. Fernandez, like all true pro-life Catholics, has an uncomfortable existence in the Democratic party. But he views the HHS mandate as an institutionalization of a secularization that goes a step too far, treating Catholicism and religion itself as enemies of basic human rights and health care.

"I believe a line was crossed," he says, referring to the White House rupture of a previous bipartisan consensus on conscience rights. "The respect for belief no longer matters. Mutual respect no longer matters. The opportunities for abuse are endless. When conscience goes, then society can be manipulated to believe that there is no moral authority. The moral authority becomes the latest fad, the politically expedient, and the will of the powerful."

And that is part of a trend in health care that disturbs Fernandez. "I bring life into the world. I am there when that child breathes for the first time. It is an honor and a responsibility. I can't do abortions; I can't prescribe abortifacients. That is causing a death. There is a distinct human with its own DNA, unlike any human before or any human after, inside that person," the doctor says.

"My concern is that if the HHS mandate holds, hospitals and physicians will have to take certifications -- online courses -- in abortion to maintain their licenses, and their medical-insurance memberships," Fernandez worries. "I won't take that course. I can lose my career if I don't accept the status quo. Conscience is not about what the majority or the powerful believe. It is that which allows each doctor to be true to oneself. I fear that euthanasia and physician-assisted suicide will not be far behind."

Even as he says this, Massachusetts faces a vote on assisted suicide, one that many are predicting will launch a domino effect if legalized, under the guise of "dignity."

In his practice, Fernandez is quick to note that he is "not a perfectly faithful Catholic physician." He prescribes birth-control pills and does some tubal ligations, he tells me, but his refusal to have anything to do with abortions, and abortion-drug prescription, is more than enough to make him stand out as "ultra-conservative" among his peers.

"The respect for a child that isn't perfect is disappearing. ... It will soon be a lot easier to end a pregnancy that is thought to be abnormal," Fernandez reflects. "I fear that with first-trimester screening, there will be not just societal but economic pressures to abort a child with Down syndrome, for example, with insurance companies casting aside the 'value of each life' for the 'utility of each life.' Babies with Down's and the elderly are at risk."

He sees a dire future if we don't stand athwart the mandate yelling "stop": "It takes moral thought and moral courage to fight against the tide. I worry that the rampant secularism of our time isn't giving our kids and young adults the tools to have moral courage."

Echoing a respect for Catholic charities that Mitt Romney demonstrated at the recent Al Smith fundraising dinner in New York, Fernandez hopes that Americans will not only wake up to the religious freedom issue in this election, but that we would all consider what "a country that no longer has faith, Catholic schools, Catholic churches and Catholic hospitals" might look like. "I want them to worry about the uninsured and the illegal that are cared for by Catholic Charities clinics. I would tell them that the Church that welcomed the Italians, the Irish and the Hispanics; that educated the poor and the minorities in the South; that marched for civil rights; and that opened the hospitals for the needy needs them now."

As Cardinal Timothy Dolan reminded those watching that same charity dinner, the HHS mandate strikes at the heart of religious freedom in an unprecedented way. And that's our first freedom, so this election is about freedom itself. Will we be good stewards, or will we go secular, hostile to a former "indispensible support" to our democracy? Will we become a different country, where all these worries on the heart and soul of one Virginia doctor are but the musings of one clinging to a dated definition of freedom? This is a time of choice. This doctor wants you to know about the pernicious pill we swallow if we do not carefully discern our vote.